13Insertion of end cap

An end cap may be used, depending on the final assessment of the nail length in relation to the tip of the greater trochanter.

The distance between the proximal end of the nail and the tip of the trochanter determines the appropriate length of the end cap, which is between zero and 20 mm, in 5 mm increments. The end cap is introduced using a hexagonal screwdriver.

The end cap is optional for the standard femoral nail.

Pitfall: The removal of the end cap may be very difficult if an exchange nailing is required. Bony overgrowth may require an extensive dissection of the greater trochanteric region. On the other hand, the end cap will have prevented tissue ingrowth and so, after its removal, the insertion of the extractor device is easier.